What happens after parathyroid surgery?

What happens after parathyroid surgery depends on what type of surgery is performed. The type of surgery performed depends on the specific cause of hyperparathyroidism. Hyperparathyroidism is a disease of the parathyroid glands in which excess parathyroid hormone is made by the glands, causing high calcium levels in blood. Too much calcium in blood may cause numerous symptoms including bone pain, kidney stones, muscle weakness, osteoporosis, osteopenia, abdominal cramping, depression, memory loss, and fatigue. Excess parathyroid hormones may be produced due to abnormal growth of one parathyroid gland, two parathyroid glands, three parathyroid glands, or all four parathyroid glands. In the majority of cases, only one parathyroid gland is affected. However, in some patients multiple glands are affected and this may or may not be known before surgery. The calcium levels in the blood do not depend on how many glands are involved. One abnormal gland can lead to just as high of calcium levels in the body as four abnormal glands. The only way to try to determine the number of glands involved before surgery is a sestamibi scan.

If only one parathyroid gland is removed during surgery, the patient can often go home the same day if they choose. Whether the patient stays overnight in the hospital or goes home, there will be frequent blood test to measure calcium levels in the blood during the first days and weeks. These tests are to monitor patients for too low calcium levels in the blood. Like too much calcium in the blood, too little calcium in the blood can also cause a number of problems. In addition to these tests, the patient will follow-up with their doctor approximately one week after surgery and several other times in subsequent months.

If multiple parathyroid glands must be removed to control the disease, the patient will have to remain in the hospital for at least one day to monitor calcium levels closely. With more glands removed, there is a greater chance that calcium levels in the blood will drop too low. Therefore, frequent blood tests will monitor calcium levels in the blood. After discharge from the hospital, these patients will also follow-up regularly with their doctor.

If calcium levels do drop to low, calcium and vitamin D supplementation will be prescribed. Patients who have had parathyroid surgery need to be monitored with a calcium blood test at least once a year to ensure there is not an elevated calcium level, as occasionally the disease can recur.